| NPI | 1588632160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME106360) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX M0403) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2020-10-08 |